Catheter-associated septic thrombophlebitis

The clinical presentation and results of management of septic thrombophlebitis in 35 patients over a seven-year period are reviewed. There were 25 men and ten women; 20 patients were over age 50. At diagnosis, fever was present in 33 patients (94%), and 33 (94%) had local signs of inflammation. Pus was expressed from the infusion site in 25 patients (71%). All patients had plastic catheters, with 95% present longer than 48 hours. Klebsiella-Enterobacter was the dominant organism both at the infusion site and in the blood. All patients had surgical excision of the infected vein, followed in 60% by rapid lysis of fever. Other infections were responsible for persistent fever after total excision. Septic thrombophlebitis is best prevented by strict asepsis in catheter placement and rotation of infusion sites every 48 hours. Total excision of the infected vein remains the treatment of choice.